Death at Twin Cities Pavilion prompts investigation (DOCUMENTS)

Published: Tuesday, March 11, 2014 at 05:42 PM.

NICEVILLE — The death of a resident at Twin Cities Pavilion who got sick after picking up pills prescribed for someone else appears to have sparked investigations by two state agencies.

A complaint that made reference to the Jan. 13 death was lodged Jan. 31 with the Agency for Health Care Administration. Investigators with the Florida Attorney General’s Office visited the facility on John Sims Parkway for the first time Feb. 3, records indicate. AHCA officials visited Feb. 6.

“I think all of the sequence of events happened after he passed away,” Kim Fraley, the director of the assisted living facility, said of the state inspections. “They came in after they received a complaint.”

The AHCA says the man whose wife described him as subject to “times of confusion” had taken a full bottle of nitroglycerin off a medical technician’s desk in an unlocked “medication room.”

The wife told investigators “she did not know he had the pills until he got sick one night and she found them in his pocket.”

She said on the night he was hospitalized Jan. 3, she noticed her husband becoming progressively weaker as he was getting ready for bed.

A staff member summoned to help found the man’s blood pressure to be low and called EMS.

The bottle of nitroglycerin — used to treat cardiac conditions — was half-empty when the wife found it, according to the AHCA report.

The report states the bottle of nitroglycerin found in the man’s pocket had remained on the med tech’s desk long enough for questions about it to be raised.

When asked about the drugs, the medical technician “would become very confrontational about it,” the report said, citing a staff member’s testimony.

The AHCA report said large quantities of hydrocodone and at least two 30-pill orders of Lortab were missing. Both drugs are potent and used as pain relievers.

Niceville Police Lt. Michael Whitfield said the investigation is just getting underway.

ACHA’s two-day investigation led to nine findings of failure to comply with state standards. It gave the facility five days to come into compliance with a directed plan of correction, according to agency spokeswoman Shelisha Coleman.

Coleman said another inspection will be conducted at a random time. Failure to address concerns could lead to fines, a moratorium on admissions or even closure, Coleman said.

“They are serious violations,” she said. “Anytime patients are at risk it’s serious to us. We take any deficiency seriously.”

NICEVILLE — The death of a resident at Twin Cities Pavilion who got sick after picking up pills prescribed for someone else appears to have sparked investigations by two state agencies.

A complaint that made reference to the Jan. 13 death was lodged Jan. 31 with the Agency for Health Care Administration. Investigators with the Florida Attorney General’s Office visited the facility on John Sims Parkway for the first time Feb. 3, records indicate. AHCA officials visited Feb. 6.

“I think all of the sequence of events happened after he passed away,” Kim Fraley, the director of the assisted living facility, said of the state inspections. “They came in after they received a complaint.”

The AHCA says the man whose wife described him as subject to “times of confusion” had taken a full bottle of nitroglycerin off a medical technician’s desk in an unlocked “medication room.”

The wife told investigators “she did not know he had the pills until he got sick one night and she found them in his pocket.”

She said on the night he was hospitalized Jan. 3, she noticed her husband becoming progressively weaker as he was getting ready for bed.

A staff member summoned to help found the man’s blood pressure to be low and called EMS.

The bottle of nitroglycerin — used to treat cardiac conditions — was half-empty when the wife found it, according to the AHCA report.

The report states the bottle of nitroglycerin found in the man’s pocket had remained on the med tech’s desk long enough for questions about it to be raised.

When asked about the drugs, the medical technician “would become very confrontational about it,” the report said, citing a staff member’s testimony.

The AHCA report said large quantities of hydrocodone and at least two 30-pill orders of Lortab were missing. Both drugs are potent and used as pain relievers.

Niceville Police Lt. Michael Whitfield said the investigation is just getting underway.

ACHA’s two-day investigation led to nine findings of failure to comply with state standards. It gave the facility five days to come into compliance with a directed plan of correction, according to agency spokeswoman Shelisha Coleman.

Coleman said another inspection will be conducted at a random time. Failure to address concerns could lead to fines, a moratorium on admissions or even closure, Coleman said.

“They are serious violations,” she said. “Anytime patients are at risk it’s serious to us. We take any deficiency seriously.”